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CAH251305-00 LAWRENCE COUNTY HOSPITAL (Active)
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Main Details
Name
LAWRENCE COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH251305-00
Medicare Provider Number
251305
Additional Details
Current Program Status
Active
Registration Date
7/14/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/29/2015
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Lawrence County Hospital
Phillip Wayne Langston, CEO
(601) 587-1202
Primary Contact
Lawrence County Hospital
Jessica Sartin, Pharmacist
(601) 587-1236
Addresses
Street Address
1065 EAST BROAD ST
MONTICELLO, MS 39654
Billing Address
Lawrence County Hospital
P.O. Box 788
Monticello, MS 39654-0788
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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7/29/15 Participated starting 7/1/12, terminated 10/1/13 due to failure to recertify, reinstated based on new registration submitted in July 2015
07/29/2015
April 2025
April 2025
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